71 year-old man on active surveillance for prostate cancer. PSA of 4.5 ng/mL.
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Finding: The right anterior TZ demonstrates a region of homogeneous moderately decreased T2 signal, although lacking the classic “erased charcoal” appearance of TZ tumors on T2WI. The lesion also shows markedly decreased ADC and increased high b-value signal.
T2WI: 3. DWI: 4.
PI-RADS: 3.
MRI/TRUS fusion biopsy: Gleason score 4+3 tumor.